221 Factors Influencing Social Maturity Among Obese Children at Elementary School in Surakarta

Abstract

Background: Identification of tissue acidosis (TA) is important in the management of sick, extremely low birthweight infants (ELBW). Previous work has suggested that anion gap may be a more accurate reflection of tissue acidosis than base deficit (Stewart, 1983). Hypoalbuminaemia leads to underestimation of anion gap (Durward et al, 2003).Aims: To estimate the incidence of hypoalbuminaemia in ELBW infants during the first 72 hours of life, and its effect on estimation of TA in a retrospective, observational study.Methods: Infants with birthweight Ͻ1000g admitted to a tertiary neonatal intensive care unit were studied. Blood gas samples were pooled with results of laboratory electrolyte, albumin and haematology assays at 0, 24, 48 and 72 hours of life. The base deficit (BD) and anion gap (AG) were calculated and then corrected for albumin using Figges formula (Corrected AG ϭ AG ϩ 0.25*(40 -albumin g/L)). TA was quantified by strong ion gap ϩ lactate, a method which has been validated previously (Stewart, 1983), and raised TA defined as Ͼ3mEq/L.Results: 104 samples were collected from 26 infants (median birthweight 708g; median gestation 25ϩ6 weeks). The incidence of hypoalbuminaemia (Ͻ25g/l) on admission was 100% and extreme hypoalbuminaemia (Ͻ20g/L) 50%. BD had the weakest correlation with TA (r2ϭ0.25, pϽ0.0001). Correction of the AG demonstrated the best correlation with TA (r2ϭ0.91, pϽ0.0001). Due to the incidence of hypoalbuminaemia, AG underestimated the corrected AG by 5.1mEq/L. Of 95 samples demonstrating TA, 46.3% had BD Ͼ5mEq/L, whereas 75.8% had corrected AG of Ͼ16mEq/L. Corrected AG identified TA on 28 occasions where BD Ͻ5mEq/L.Conclusions: Base deficit is a poor marker of TA in ELBW infants. Hypoalbuminaemia is a universal finding in this population. Failure to correct the anion gap for hypoalbuminaemia may lead to underestimation of TA, which may have treatment implications. Purpose: Thymic size can be affected by glucocorticoids. Glucocorticoids increase surfactant synthesis in preterm infants. We assessed the hypothesis that fetal lung maturity in preterm infants correlates with thymus size detected at birth on routine chest radiograph. We also searched for a possible relationship between thymus size, respiratory distress syndrome, and the cord blood cortisol level. THUMUS SIZE AND ITS RELATIONSHIP TO THE RESPIRATORY DIS-TRESS SYNDROME AND CORD BLOOD CORTISOL LEVEL IN THE PRE-TERM INFANTSMethods: The cardiothymic/thoracic ratio within 3 hours after birth and cord blood cortisol level were measured in 42 preterm infants admitted to the neonatal intensive care unit of Seoul National University Children's Hospital from June 2002 to December 2003. Multiple linear regression analysis was done to assess the relationships between cardiothymic/thoracic ratio, perinatal events and cord blood cortisol. The receiver operation characteristic curve analysis was done to evaluate the cardiothymic/thoracic ratio in the prediction of respiratory distress syndrome.Results: 8 infants (19.0%) developed respiratory di...

Perbedaan Kematangan Sosial Siswa yang Berasal dari Sekolah Homogen dan Sekolah Heterogen

“…Disamping faktor internal seperti coping skill (Lestari, Hidayah, Suci, Riza, & Martuti, 2005;Nicholls, Perry, Jones, Morley, & Carson, 2013;Sadeghi & Niknam, 2015), lingkungan juga memberi pengaruh yang cukup signifikan terhadap kematangan sosial. Lingkungan, termasuk lingkungan sekolah merupakan salah satu faktor penting yang memengaruhi kematangan sosial individu.…”